Condoms for 250,000 teens New York City acts for public health

Howard Markel

March 01, 1991|By Howard Markel

IN APPROVING a plan Wednesday to make condoms available to 250,000 high school students, the New York City school board distinguished itself, overcoming faulty reasoning, sarcasm, illogical use of statistics and perverse cynicism.

But it is because of the heated confusion that swirled around the New York plan for months that society must grapple with the complex problem of successfully fighting sexually transmitted diseases, including the one that threatens and embarrasses so many Americans: AIDS.

Many groups have made repeated attempts to sabotage this and similar public health efforts throughout the nation before an appropriate and rational strategy can even be implemented or tested. One fundamentalist group called Human Life International has threatened to file suit against the public school system if "one child" using a New York City-distributed condom contracts AIDS, some other sexually transmitted disease or becomes pregnant. An equally inappropriate use of an already overburdened judicial system would be for a parent of an AIDS-stricken student to sue the New York schools for not handing him or her a condom.

But let us avoid the political and legal machinations which have repeatedly imposed themselves on the implementation of programs to safeguard public health.

In spite of the controversies and intense fervor that automatically accompanies all issues concerning sexuality and reproduction, we need to examine some harsh facts about teen-agers and their level of sexual activity:

Teens are initiating sexual activity at younger and younger ages, while the number of sexual partners a teen-ager encounters in a 12-month period rises with each passing year.

Teen pregnancies continue to occur at a rate of over 1 million annually; "unsafe" sexual activity and sexually transmitted diseases, including gonorrhea, chlamydia and human papilloma virus are literally epidemic among teens, especially among those living in impoverished, urban settings like Baltimore.

True, condoms do not provide their users with a 100 percent effective defense against sexually transmitted diseases, including AIDS, or against pregnancy. Failure rates can vary, between 7 and 13 percent, depending on the quality of the product, its proper use and a number of other factors.

But for those who continue to be sexually active in an era haunted by the specter of AIDS, condoms certainly offer more protection than nothing at all. Teen-agers are engaging in unprotected sexual activity in record numbers. There are grave risks in such behavior. Aren't these young people entitled to as much protection and education as we "rational" adults can facilitate?

Howard Markel, M.D., is a clinical fellow in adolescent medicine at Johns Hopkins University School of Medicine.

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